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General NPI Number Information
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NPI Number | 1184096315
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Entity Type | Organization
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Legal Business Name | PATRICIA L. JENSEN, LMFT
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 1600 FRONT ST
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City | EAST MEADOW
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State | NY
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Zip | 11554-2330
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Country | US
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Telephone | 516-445-5191
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 FRONT ST
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City | EAST MEADOW
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State | NY
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Zip | 11554-2330
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Country | US
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Telephone | 516-445-5191
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE & FAMILY THERAPIS
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Name | PATRICIA LYNN JENSEN
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Credential | LMFT
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Telephone | 516-445-5191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001197
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License Number State | NY
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